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The investigations were aimed at examining the impact of methodically simple separating and enriching techniques for gaining granulocytes on the bactericidal capacity and NBT reduction in isolated granulocytes. For this purpose, granulocytes were gained by the technique of sedimentation and flotation. Granulocytes isolated by the cell separator Haemonetics model 30 were used as reference material. The findings of the investigations together with those of previous studies revealed no indication of the granulocyte function and morphology being damaged by the separating techniques used.

The percentage nitroblue-tetrazolium (NBT) leucocyte levels were evaluated daily in the 10 days following a first attack of coronary thrombosis. In 12 uncomplicated cases the peak increase was on the second or third day; thereafter the level declined and was below 10% by the tenth day. Three other patients did not conform to this pattern of NBT behaviour. They had experienced a second myocardial infarction and this was attended by a secondary rise in the NBT score; in the two survivors the score remained elevated on the tenth day. Comparison of the score on the second-third and tenth-fourteenth days is a possible useful index of a further complication.

A modification of the NBT-reaction is described which allows a differentiation of the NBT uptake and NBT-reduction. By means of this method it has been shown that the capacity of NBT-reduction of neutrophil granulocytes taken from hematologically healthy persons is independent of the probands' age and, moreover, of the presence of acute infections and their etiology. It has been shown, that the increase in the NBT-reduction of neutrophilic granulocytes of newborns and persons with acute bacterial infections results from an increased NBT-ingestion. To grive an example of a strongly reduced capacity of NBT-reduction of the neutrophilic granulocytes 2 patients suffering from fatal granulomatous disease in childhood have been examined.

This study was designed to ascertain the effect of prolonged hemorrhagic hypotention on nitroblue tetrazolium (NBT) reduction by neutrophils and, consequently, to determine whether the qualitative NBT test is a reliable aid to rapid detection of systemic bacterial infection and endotoxemia after severe hemorrhage. Nitroblue tetrazolium reduction by neutrophils did not appear significantly altered by 2 hours of hemorrhagic hypotension in dogs, but moderate increase in NBT-positive neutrophils was observed after the reinfusion of shed blood. More importantly, leukocytes from shock blood did increase NBT reduction under endotoxin stimulation. These findings imply that the NBT test is a reliable indicator of systemic bacteria and endotoxin prior to resuscitation with stored blood, but in the immediate postreinfusion period, increased NBT metabolism in phagocytic leukocytes may represent either systemic bacterial invasion or neutrophil damage secondary to blood storage and in vivo metabolic derangements associated with shock.